U.S. Chief District Judge William Young of the U.S.
District Court for the District of Massachusetts ruled
that the plaintiff, only identified in court documents as
“John Doe,” should have received disability
benefits

According to Young’s ruling, First Unum maintained
that Doe could not be considered disabled due to the
schizophrenia before June 1999, but that his coverage
ended in April 1999 when he stopped working at law firm
Hawkins, Delafield & Wood. For his part, Doe asserted
that he was, in fact, disabled before April and that his
employment with the firm continued until June 30,
1999.

Young quoted First Unum documents as saying that
Doe was fired because of “inability to handle the
workload, poor attention, poor concentration, and
diminished social interactions.” Those issues, Young
asserted in the ruling, were “a list of failings that
bore a striking resemblance to the outward manifestations
of schizophrenia.” Young decided that Doe had become
disabled while a firm employee and, therefore, was
entitled to benefits.

“First Unum acted in bad faith in denying benefits
to Doe, and while First Unum’s position was entirely
without merit, (Doe) was essentially correct. The company
can well afford to pay a fee award, and the awarding of
fees against insurers acting in bad faith would deter
similar conduct by other insurers in the future,” Young
wrote. “… to the extent that other participants and
beneficiaries exist, the decision that has resulted from
the bringing of this case ought certainly change First
Unum’s practice of denying valid claims based on an
erroneous and highly restrictive interpretation of the
policy.”